Abstract
Author(s): Amal Muner Mubarak*, Aseel Abdulameer Mohammed, Dalal M Jarrah, Zahraa F. Alhilli
Background: Luteal phase support (LPS) after ICSI is a critical step, with progesterone being the standard treatment. However, the benefit of adding estradiol to this support remains controversial. Objective: To evaluate the effect of adding oral estradiol to progesterone for luteal phase support in patients undergoing ICSI/ET. Design: Prospective cohort study. Setting: Fertility Center, Alsader Teaching Hospital, Najaf. Patients and Methods: A total of 180 subfertile women aged 18-35 years, undergoing ovarian stimulation and ICSI, were randomly divided into two groups for luteal phase support. The progesterone-only group (n=90) received vaginal progesterone (400 mg twice daily) and oral dydrogesterone (20 mg daily). The progesterone plus estradiol group (n=90) received oral estradiol (4 mg daily) in addition to the progesterone regimen. Results: Demographic characteristics, stimulation parameters, and embryological data were comparable between the two groups. The clinical pregnancy rate was higher in the estradiol group (43.3%) compared to the progesterone-only group (36.7%), though this difference was not statistically significant. No significant differences were observed in ongoing pregnancy rates, early pregnancy loss, or multiple pregnancy rates between the groups. However, the implantation rate was significantly higher in the estradiol plus progesterone group (21%) compared to the progesterone-only group (13%) (P < 0.001). Conclusion: The addition of oral estradiol (4 mg) to progesterone in patients undergoing ICSI did not significantly improve overall pregnancy outcomes. However, the implantation rate was significantly higher in the estradiol plus progesterone group.